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Common Conversions: 1 Liter = 1000 Milliliters 1 Gram = 1000 Milligrams 1 Milligram = 1000 Micrograms 1 Kilogram = 2.

2 pounds

VIII. IX. X.

D=1 gm (note: need to convert to milligrams) 1 gm = 1000 mg H=250 mg V=1 capsule 250 : XI. 1 :: 1000 : X

Methods of Calculation Any of the following three methods can be used to perform drug calculations. Please review all three methods and select the one that works for you. It is important to practice the method that you prefer to become proficient in calculating drug dosages. Remember: Before doing the calculation, convert units of measurement to one system. I. Basic Formula: Frequently used to calculate drug dosages. D (Desired dose) H (Dose on hand) V (Vehicle-tablet or liquid) D x V = Amount to Give H D = dose ordered or desired dose H = dose on container label or dose on hand V = form and amount in which drug comes (tablet, capsule, liquid) Example: Order-Dilantin 50 mg p.o. TID Drug available-Dilantin 125 mg/5ml D=50 mg H=125 mg V=5 ml

250X = 1000 1000 250

X=

XIII.

XII. X = 4 capsules Fractional Equationa H D = V X

XIV.

Cross multiply and solve for X. H D = V X HX = DV X= DV H

Example: Order - Digoxin 0.25 mg p.o. QD Drug Available - 0.125 mg per tablet D=0.25 mg H=0.125 mg 0.125 0.25 = 1 X XX. 0.125X = 0.25 0.25 0.125 V=1 tablet

50 250 x5= = 2 ml 125 125 II. Ratio & Proportion: Oldest method used in calculating dosage.

X=

XXII.

XXI. X = 2 tablets Intravenous Flow Rate Calculation (two methods) Two Step Step 1 - Amount of fluid divided by hours to administer = ml/hr ml/hr x gtts/ml(IV set) Step 2 = gtts/min 60 min One Step amount of fluid x drops/milliliter (IV set) hours to administer x minutes/hour (60) Example: 1000 ml over 8 hrs

III. IV. V.

Left side are known quantities Right side is desired dose and amount to give Multiply the means and the extremes HX = DV X= DV H

Example: Order-Keflex 1 gm p.o. BID Drug available-Keflex 250 mg per capsule

IV set = 15 gtts/ml Two Step 1000 = 125 8

Solution x 60 min/hr x kg x mcg/kg/min cc = cc/hr Drug mcg Example: Dopamine 400 mg/250 cc D5W to start at 5 mcg/kg/min. Patients weight is 190 lbs. 250 cc 400,000 mcg 4. x 60 min x 86.4 x 5 mcg/kg/min = 16.2 cc/hr

Step 1 Step 2 -

125 x 15 = 31.25 (31 gtts/min) 60 One Step 1000 x 15 15,000 = = 31.25 (31gtts/min) 8 hrs x 60 480 XXIII. A. How to Calculate Continuous Infusions mg/min (For example - Lidocaine, Pronestyl) Solution cc x 60 min/hr x mg/min = cc/hr Drug mg Drug mg x cc/hr = mg/hr Solution cc x 60 min/hr Rule of Thumb Lidocaine, Pronestyl 2 gms/250 cc D5W 1 mg = 7 cc/hr 2 mg = 15 cc/hr 3 mg = 22 cc/hr 4 mg = 30 cc/hr

To calculate mcg/kg/min Drug mcg/ x cc/hr = mcg/kg/min Solution cc x 60 min/hr x kg Example: Nipride 100 mg/250 cc D5W was ordered to decrease your patients blood pressure. The patients weight is 143 lbs, and the IV pump is set at 25 cc/hr. How many mcg/kg/min of Nipride is the patient receiving? 100,000 mcg x 25 cc/hr 2,500,000 = 250 cc x 60 975,000 min x 65 kg = 2.5 mcg/kg/min

A.

How to calculate mcg/kg/min if you know the rate of the infusion Dosage (in mcg/cc/min) x rate on pump Patients weight in kg

= mcg/kg/min

D.

mcg/min (For example - Nitroglycerin) Solution cc x 60 min/hr x mcg/min = cc/hr Drug mcg Drug mcg x cc/hr = mcg/hr Solution cc x 60 min/hr Rule of Thumb NTG 100 mg/250 cc 1 cc/hr = 6.6 mcg/min NTG 50 mg/250 cc 1 cc/hr = 3.3 mcg/min

B.

For example: 400mg of Dopamine in 250 1600 mcg/cc cc D5W = 60 min/hr = 26.6 mcg/cc/min

C.

D. E.

26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all drug calculations. Once you do this step, you can do anything! NOW DO THE REST! If you have a 75 kg patient for example... 26.6 mcg/cc/min x 10 cc on pump = 3.54 mcg/kg/min Patientss weight in kg (75 kg) = 3.5 mcg/kg/min (rounded down)

G.

mcg/kg/min (For example - Dopamine, Dobutamine, Nipride, etc.) To calculate cc/hr (gtts/min)

1.

F.

How to calculate drips in cc per hour when you know the mcg/kg/min that is ordered or desired mcg/kg/min x patients weight in kg dosage concentration in mcg/cc/min

= rate on pump

G. H.

For example: 400 mg Dopamine in 250 cc D5W = 26.6 mcg/cc/min 3.5 mcg/kg/min x 75 kg = 9.86 cc 26.6 mcg/cc/min = 10 cc rounded up

I. J.

ALWAYS WORK THE EQUATION BACKWARDS AGAIN TO DOUBLE CHECK YOUR MATH! For example: 10 cc x 26.6 mcg/cc/min = 3.5 mcg/kg/min 75 Kg Dosage (in mcg/cc/min) x rate on pump Patients weight in kg = mcg/kg/min

L. M. N.

O. P.

For example: 400mg of Dopamine in 250 cc D5W = 1600 mcg/cc 60 min/hr = 26.6 mcg/cc/min 26.6 is the dosage concentration for Dopamine in mcg/cc/min based on having 400 mg in 250 cc of IV fluid. You need this to calculate this dosage concentration first for all drug calculations. Once you do this step, you can do anything! NOW DO THE REST!! If you have a 75 kg patient for example 26.6 mcg/cc/min x 10 cc on pump Patientss weight in kg (75 kg)

= 3.54 mcg/kg/min